Brown Gregory, Bustamante-Paytan Diego, Albujar Pereira María Fe, Huilca Jose, Agüero Katherine, Verastegui Graciet, Yauri Zadith, Montesinos Rosa, Custodio Nilton
Unidad de Investigación, Instituto Peruano de Neurociencias, Lince, Peru.
Department of Neurology, University of California, San Francisco, CA, USA.
J Alzheimers Dis Rep. 2025 Apr 17;9:25424823251335193. doi: 10.1177/25424823251335193. eCollection 2025 Jan-Dec.
Time to dementia diagnosis is a major barrier to effective care, particularly in resource-limited settings such as Latin America. Barriers to timely dementia diagnosis include the lack of access to comprehensive neuropsychological testing, cognitive specialists, and advanced diagnostic tools. Brief cognitive assessments, such as the Rowland Universal Dementia Assessment Scale (RUDAS) and INECO Frontal Screening (IFS) offer promise for diverse populations, and may help in specific dementia subtypes, including Alzheimer's disease (AD) and Parkinson's disease dementia (PDD).
This study evaluates the efficacy of RUDAS and IFS in comparison to the Mini-Mental Status Exam (MMSE).
A total of 243 participants (70 normal cognition Controls, 62 PD with normal cognition, 46 PDD, and 75 AD) were recruited as part of an observational cross-sectional study at a cognitive clinic in Peru. Diagnosis was based on clinical criteria and confirmed with a comprehensive neuropsychological battery. Participants underwent cognitive assessment using RUDAS, IFS, and MMSE.
Both RUDAS and IFS differentiated dementia from normal cognition groups with 100% specificity, compared to 53% for MMSE. The IFS identified early cognitive changes in PD (median score: PD = 24; Controls = 27, p < 0.001). RUDAS was particularly effective in distinguishing AD and PDD using the memory and visuospatial tasks.
These results suggest that RUDAS and IFS can enable faster and clearer diagnoses for dementia subtypes, offering clinicians and community health workers practical tools to improve care in resource-limited settings where comprehensive evaluations are not always feasible.
痴呆症诊断时间是有效护理的主要障碍,尤其是在拉丁美洲等资源有限的环境中。及时进行痴呆症诊断的障碍包括缺乏全面的神经心理学测试、认知专家和先进的诊断工具。简短的认知评估,如罗兰通用痴呆评估量表(RUDAS)和INECO额叶筛查(IFS),对不同人群具有应用前景,可能有助于特定的痴呆症亚型,包括阿尔茨海默病(AD)和帕金森病痴呆(PDD)。
本研究评估RUDAS和IFS与简易精神状态检查表(MMSE)相比的有效性。
作为秘鲁一家认知诊所的观察性横断面研究的一部分,共招募了243名参与者(70名认知正常的对照者、62名认知正常的帕金森病患者、46名帕金森病痴呆患者和75名阿尔茨海默病患者)。诊断基于临床标准,并通过全面的神经心理测试组进行确认。参与者使用RUDAS、IFS和MMSE进行认知评估。
与MMSE的53%相比,RUDAS和IFS区分痴呆症与正常认知组的特异性均为100%。IFS识别出帕金森病的早期认知变化(中位数得分:帕金森病患者=24;对照者=27,p<0.001)。RUDAS在使用记忆和视觉空间任务区分阿尔茨海默病和帕金森病痴呆方面特别有效。
这些结果表明,RUDAS和IFS能够更快、更清晰地诊断痴呆症亚型,为临床医生和社区卫生工作者提供实用工具,以改善在资源有限的环境中的护理,在这些环境中进行全面评估并不总是可行的。